35th APACRS Annual Meeting Final Program

FF1-13 3 FLACS Complications You May Have Never Seen Anagha HEROOR India We wish to present 3 complications of FLACS that are very rare. The 1 patient had a retained capsulotomy flap which was noticed floating in the anterior chamber the next day. The patient was then taken up for Anterior chamber wash and the flap was then aspirated. The second patient was of an anterior Chamber bleeding that was noted post completion of laser during FLACS. A 54-year-old woman with no ocular and systemic morbidity underwent right eye FLACS. Vacuum loss was noted due to patient's eye movements. Suction and docking was achieved at the second attempt following which laser treatment was uneventful. An intracameral bleed was noted superiorly extending towards the center of the anterior chamber. Cataract surgery with IOL implantation and postop course was uneventful. This is the first report in literature of intracameral bleeding during FLACS. It is essential to proceed with caution in patients with repeated vacuum loss due to higher risk of developing intraocular bleed. The 3rd patient was where an uneventful FLACS was done but even before she was taken up for phacoemulsification surgery, the patient developed dyspnea and cardiac complications and she was admitted to the intensive care unit. IOP was as high as 30 to 44 mmHg, for which she was put on anti-glaucoma medications. Vision was reduced to perception of light. She was finally taken up for phacoemulsification, she developed hyphema which was removed by AC wash. But the patient lost vision due to glaucomatous optic atrophy. FF1-14 Combined 25-gauge Vitrectomy and Cataract Surgery with Toric Intraocular Lens with Proliferative Diabetic Retinopathy Song CHEN China Toric IOLs are less frequently combined with vitrectomy surgery, because of the technical difficulty of vitreous surgery and the emphasis on retinal disease control. We showed a case with proliferative diabetic retinopathy (PDR) who combined 25-gauge vitrectomy and cataract surgery with toric intraocular lens toric IOL implantation. Corneal topography showed regular corneal astigmatism with-the-rule (4.5 D on the left eye). 25-gauge vitrectomy and cataract surgery with toric intraocular lens toric IOL (ZEISS AT TORBI 709M; cylinder power: 5.0 D) implantation were performed. The uncorrected visual acuity increased from 20/200 to 20/30. Refractive astigmatism decreased by 75%. No IOL misalignment or other complications occurred for over 3 months. FF1-15 Perfect Anterior Capsulorhexis using a "Dented Cystitome" Aditi GHOSH India A novel intraoperative technique of measuring and creating an adequate size continuous curvilinear capsulorhexis in phacoemulsification, using dented cystitome as the ruler. Curved tenotomy scissors is used to create a dent on the cystitome at a distance of 2.5 mm length (i.e. half of the desired approximate capsulorhexis diameter). The dented cystitome is used as a guide for making a continuous curvilinear capsulorhexis of approximately 5 mm diameter which is considered adequate for phacoemulsification. This method of measuring capsulorhexis helps in achieving a well-centered and stable intraocular lens with a 360-degree overlap of the optic edge by the anterior capsular rim in the postoperative period. Dented cystitome for capsulorhexis mandates reliable and consistent results in the hands of the novice as well as the experienced surgeon. FF1-16 Longitudinal Chop Against Hard/thick Nuclear Cataracts to Reduce Strain on the Zonule of Zinn Masayuki AKIMOTO Japan During disassembling harder/thicker nuclear cataract, surgeons may damage the Zonule of Zinn by pushing the nucleus with a phacochopper and a phaco-tip. To avoid damaging the zonule, a phacochopper, as thin as the wire of miLOOP® and thinner than a phaco-tip, is inserted behind the bottom of the nucleus, and then the nucleus can be crushed by sandwiching with a phaco-tip longitudinally. FF1-17 A New Angle in Phaco Cracking Aditi GHOSH India Beginners in phacoemulsification face a range of problems with conventional techniques when the main port and sideport incision lie 90 degrees apart as this creates difficulty in effectively placing the phaco probe and chopper into the depth of the trench, wound manipulation can cause corneal folds, zonular stretch, PCR, and the surgeon may struggle with nucleus cracking. Concerned with quality, a sincere modification in the cracking step is done where the main port and sideport incision lie 60 degree apart and the groove is made at 30 degrees so that the groove has adequate dimension. The nucleus is divided effortlessly with the advantages being no corneal folds at the sideport, nil zonular stretch, and less phaco time. This simple maneuver being taught to phaco beginners may result in shorter learning curve with better results. FILM FESTIVAL 94